Militias and gangs are kidnapping medical workers at an alarming rate in Syria’s rebel-controlled north-west. Doctors and pharmacists appear most vulnerable, with at least 12 abducted in the province of Idlib this year. But paramedics and administrative health workers have also gone missing, say activists and rights groups.

The rise in kidnappings has become one of the main concerns for civilians since Turkey and Russia agreed to establish a buffer zone in Idlib on September 17. The agreement staved off a looming regime offensive, which risked triggering a humanitarian catastrophe.

Activists on the ground say that the agreement has largely held so far. But with Hayat Tahrir Al Sham, an Al Qaeda offshoot, still the dominant force in north-west Syria, medical workers say they have to operate cautiously.

A monitor from one aid group said that HTS was primarily to blame for the disappearance of doctors and pharmacists. Others maintain that bandits and gangs are responsible for the bulk of the kidnappings.

The latest victim was a pharmacist, Ibrahim Radhwan, whose job was to monitor pharmacies across Idlib. He was abducted by gunmen on October 31 while making his rounds. That day his family received a message from an unknown number. It was his captors, demanding a $1 million (Dh3.67m) ransom for Radhwan’s release.

“Sell everything we have including our businesses. We just have one week to hand over the money,” Mr Radhwan said in a voice message that was sent to his family and shared with The National. “If you don’t co-operate then they will make my life a living hell. It’s really cold [in the room they’re keeping me in] and they told me if [my family] doesn’t pay then I won’t see the light.”

Mr Radhwan had still not been released on Saturday, more than a week after his capture.

The head of the health directorate in Idlib, Safwat Shaikhuny, said that most kidnappers demand an unrealistic ransom, but often negotiate with the families of captives. Some people paid as much as $100,000 to secure the release of their loved ones, he said.

“In most cases, an agreement is always reached and a ransom is paid. But nobody ever finds out about the identities of the kidnappers,” Mr Shaikhuny told The National.

Dr Mohammad Katoub, the advocacy officer for the Syrian American Medical Society, which supports medical facilities in rebel-controlled Syria, said that the high salaries of doctors and pharmacists make them a target. Most earn between $1,000 and $1,500 a month, which is more than 10 times the average wage in north-west Syria.

But money might not be the only motive. The abduction of health workers also appears to be part of a broader campaign to silence prominent activists and aid workers.

“The kidnapping of well-known doctors was definitely premeditated,” Dr Katoub said. “It’s clear that these kidnappings are becoming systematic. Medical workers in the north-west are more in danger from armed groups than at any other point in the conflict.”

Six medical workers - doctors and pharmacists — are still missing after being abducted in Idlib this year.

Pharmacist Najdet Sallat says that he is lucky he is not one them. On May 10, he was kidnapped by a gang and held captive for four days, during which he was beaten and subjected to electric shocks. The torment ended after his family paid a ransom of $18,000. Fearing he might be kidnapped again, Mr Sallat says that he no longer strays far from his home or pharmacy.

“I gave up my work as a monitor. I’m just not free to roam Idlib like I was before,” he said. “My mother and I are very scared. I don’t want to relive another kidnapping.”

Armed groups are also abducting medical workers in the western countryside of Aleppo. Paramedic Alaa Alawi was snatched two months ago, yet he escaped on October 19 after HTS raided the house where he was held captive, said Abd Al Nasser, the head of the health directorate in the Aleppo countryside.

Many medical workers have reportedly thought about stopping work because of the risk they face. Some aid organisations said they might even terminate their relief services if abductions persist. But Mr Al Nasser stressed that hospitals and clinics cannot afford to lose any more personnel since these facilities are already undermanned in Syria’s north-west.